SMJ // February 2019, Volume 112 - Issue 2

Original Article

Outcomes in Patients with Left Ventricular Assist Devices, Pacemakers, and Implantable Cardioverter Defibrillators Undergoing Single Balloon Enteroscopy

Objectives: Obscure overt gastrointestinal bleeding can be challenging to evaluate in patients with electronic cardiac devices such as continuous flow left ventricular assist devices (LVADs), pacemakers (PPMs), and implantable cardioverter defibrillators (ICDs). Limited data exist on the utility and safety of single balloon enteroscopy (SBE) in patients with cardiac devices….

Perspectives

Addressing Mental Health Needs among Physicians

Physician burnout is a national phenomenon with far-reaching implications for health systems, patients, patient care, and clinicians.1–5 Burnout is related to clinically significant depression6 and anxiety7; doctors have overall prevalence rates of depression that are similar to the general population,8 and in medical students and residents the rates are even…

Perspectives

Curing Health Care by Adding Value: How About a Physical Examination?

New diagnostic technologies … telemedicine on your mobile phone … online portals for reviewing test results and scheduling appointments … electronic medical records … paperless physician’s office—these are cornerstones of the modern healthcare experience in the United States today, but are we really getting what we want? To know the…

Invited Commentary

Commentary on “Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015”

In response to the sentinel Institute of Medicine report on emerging infectious diseases,1 the Centers for Disease Control and Prevention (CDC) published a national strategy for infectious disease prevention in 19942 and created the Emerging Infection Program (EIP) in 1995. As part of the Emerging Infection Program, the Epidemiology and Laboratory…

Posted in: Infectious Disease139

Original Article

What Attracts Medical Students to Primary Care? A Nominal Group Evaluation

Objective: To examine the perceptions of first-year medical students on their experiences in primary care. Methods: Nominal group technique sessions were conducted with first-year medical students for 5 years. Questions were designed to evaluate primary care experiences and the role of primary care physicians. The questions explored what would make…

Original Article

FREE: The Importance of Health and Social Services Spending to Health Outcomes in Texas, 2010–2016

Objectives: Public health and social services spending have been shown to improve health outcomes at the county level, although there are significant state and regional variations in such spending. Texas offers an important opportunity for examining nuances in the patterns of association between local government health and social services spending…

Original Article

Cancer Risk Awareness among Uninsured Primary Care Patients

Objectives: Underserved populations are at risk of low cancer risk awareness. The purpose of this study was to examine cancer risk awareness and lifestyle issues among uninsured primary care patients in the United States. Methods: Data were collected using a self-administered survey from May to July 2017 of adult free…

Posted in: Medical Oncology37

Original Article

Can C-Reactive Protein Be Used to Predict Acute Septic Arthritis in the Adult Population?

Objectives: The objective of this study was to establish whether C-reactive protein (CRP) could be used to predict native joint septic arthritis (SA) in the adult population. Methods: All patients who underwent native joint aspiration in accident and emergency settings between April 2012 and September 2016 were identified from laboratory…

Original Article

Comparison of Medical Student Communication Skills Measured by Standardized Patients During an OSCE and by Faculty During an In-Hospital Encounter

Objectives: At our institution, learner communication skills during an objective structured clinical examination (OSCE) are measured by standardized patients (SPs) using the New Mexico Clinical Communication Scale (NM-CCS). Faculty physicians also conduct a direct observation of a clinical encounter (DOCE) to observe students’ interactions with real hospitalized patients. The objective…

Original Article

Signed, Sealed, Delivered: Increasing Patient Notification of Test Results in an Internal Medicine Resident Continuity Clinic

Objectives: Informing patients of their test results is an important patient safety issue, yet many physicians perform dismally in this regard. Residents often face additional barriers to communicating test results to patients. We wanted to determine whether streamlining the notification process, communicating expectations, and having residents audit their performance would…

Perspectives

OPEN: Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Because clinicians may be the first to encounter cases of emerging infectious diseases, they need to be able to work together with public health departments to quickly identify and respond to infectious disease outbreaks. Infectious diseases are a constant threat in many parts of the United States, including rural areas….

Posted in: Infectious Disease139

Perspectives

Healthcare Disparities in People with Disabilities: Is There a Cure?

The National Prevention Council, formed under the Patient Protection and Affordable Care Act of 2010 (PL 111–148), identifies a health disparity as a difference in health outcomes across subgroups of the population that often is linked to social, economic, or environmental disadvantages.1

Original Article

CME Article: Imaging in Acute Pyelonephritis: Utilization, Findings, and Effect on Management

Objectives: To determine the frequency, timing, and types of imaging obtained in patients with a discharge diagnosis of acute pyelonephritis, and how often imaging findings affect therapy. Methods: This was a retrospective chart review of 1062 adults with a diagnosis of acute pyelonephritis discharged from an urban, safety-net hospital between…

Posted in: Nephrology and Urology23 Other Kidney Disorders1

Invited Commentary

Commentary on “What Attracts Medical Students to Primary Care? A Nominal Group Evaluation”

Weiland and colleagues1 should be commended for their work in the area of primary care choice that appears in this issue of the Southern Medical Journal. As our nation struggles with a primary care provider shortage, new and innovative strategies are required. This article describes the results of interviews with…

Multidisciplinary Clinical Case Study

An Underappreciated and Prolonged Drug Interaction Leads to Ineffective Anticoagulation

A poorly understood significant drug–drug interaction compounded by ineffective communication among providers at times of care transition most likely contributed to multiple thromboembolic events in an 81-year-old patient. Increased awareness of drug interactions with direct oral anticoagulants (DOACs), as well as improved communication among inpatient and outpatient providers at the…

Posted in: Hematology10
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